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https://www.readbyqxmd.com/read/29226531/pre-implant-left-ventricular-apex-position-predicts-risk-of-heartmate-ii-pump-thrombosis
#1
Leora T Yarboro, James Hunter Mehaffey, Robert B Hawkins, Irving L Kron, Gorav Ailawadi, John A Kern, Ravi K Ghanta
BACKGROUND: Thrombosis within a left ventricular assist device (LVAD) is a devastating complication that often necessitates device exchange. Few studies have evaluated the relationship between patient anatomy and pump thrombosis. We hypothesize that lateral displacement of the left ventricular (LV) apex increases risk for pump thrombosis. METHODS: All patients who underwent primary implantation of a HeartMate II (HM2) device (Thoratec, Pleasanton, CA) at a single center (2009-2015) were evaluated...
December 10, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29206805/axial-to-centrifugal-continuous-flow-lvad-pump-exchange-using-minimally-invasive-technique
#2
Amit A Pawale, Ariel Farkash, Dimosthenis Pandis, Anelechi C Anyanwu
Driveline or device infection may complicate left ventricular assist device implants, and only curative option may be pump exchange. Replacement with similar device may be liable to reinfection, because pump configuration is such that the new device and driveline may partly lie within the pocket of the previous pump. One approach to overcome this is using a different pump design such that the new pump would lie in a different location from the old pump. We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device...
December 4, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29065351/end-organ-recovery-post-ventricular-assist-device-can-prognosticate-survival
#3
Joseph Philip, Dalia Lopez-Colon, Ravi S Samraj, Giri Kaliki, Maria V Irwin, Biagio A Pietra, Frederick J Fricker, Mark S Bleiweis
BACKGROUND: This study examines our institutional ventricular assist devices (VADs) experience over two decades to understand trends towards predictors of mortality. METHODS: Retrospective study of patients aged 0-21years supported with a VAD from January 1996 to May 2015. Patient data was examined pre and post-VAD implant among survivors and non-survivors. RESULTS: Thirty-six patients identified (8 supported by Thoratec® VAD and 28 supported by EXCOR Berlin Heart®)...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28987395/abciximab-heparin-therapy-for-left-ventricular-assist-device-implantation-in-patients-with-heparin-induced-thrombocytopenia
#4
Chia-Ling Lee, Paolo C Colombo, Andrew Eisenberger, David Diuguid, Douglas L Jennings, Jiho Han, Michael P Salna, Koji Takeda, Paul A Kurlansky, Melana Yuzefpolskaya, Arthur R Garan, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Optimal anticoagulation strategy remains uncertain in patients with heparin-induced thrombocytopenia (HIT) and undergoing left ventricular assist device (LVAD) implantation. We describe our protocol of abciximab and heparin in these patients. METHODS: Our protocol is to administer abciximab, 0.25 mg/kg loading dose, followed by continuous infusion of 0.125 μg · kg(-1) · min(-1) throughout cardiopulmonary bypass. Full-dose heparin is then given with subsequent additional doses to maintain an activated clotting time of 400 seconds or longer...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28957820/risk-factors-of-gastrointestinal-bleeding-after-continuous-flow-left-ventricular-assist-device
#5
Ozlem Balcioglu, Hatice S Kemal, Serkan Ertugay, Pelin Ozturk, Yaprak Engin, Sanem Nalbantgil, Cagatay Engin, Tahir Yagdi, Mustafa Ozbaran
This study aimed to compare von Willebrand factor (vWF) levels, ristocetin cofactor levels, platelet counts, aortic valve movements, and right heart failure (RHF) as risk factors of gastrointestinal (GI) bleeding in patients with continuous flow left ventricular assist device (cf-LVAD). In a single centre, 90 patients (mean age 52.0 ± 10.5 years), of which 59 were male and 31 were female, had cf-LVAD implantation from October 2010 to November 2012. Seventy-six (84.4%) patients had HeartWare (Medtronic, Mounds View, MN) and 14 (15...
September 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28841580/durable-biventricular-support-using-right-atrial-placement-of-the-heartware-hvad
#6
Hao A Tran, Travis L Pollema, Jorge Silva Enciso, Barry H Greenberg, Denise D Barnard, Eric D Adler, Victor G Pretorius
Patients with Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1-2 who either have or are at risk for right ventricular failure face significant morbidity and mortality after continuous flow left ventricular assist device (CF-LVAD) implantation. Currently, the options for biventricular support are limited the Total Artificial Heart (TAH; CardioWest, Syncardia, Tuscon, AZ) or biventricular assist device (BiVAD), which uses bulky extracorporeal or implantable displacement pumps...
August 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28838516/cardiac-regeneration-in-the-human-left-ventricle-after-cormatrix-implantation
#7
Alice Ferng, Alana Connell, Martha Nunez, Kitsie Johnson, Beth Braunhut, Scott Lick, Ankit Desai, Toshinobu Kazui, Ray Runyan, Zain Khalpey
CorMatrix is an organic extracellular matrix (ECM) derived from porcine small intestine submucosa and is used for pericardial closure and cardiac tissue repair. During explantation of a HeartMate II (Thoratec Corp, Pleasanton, CA) left ventricular assist device (LVAD) because of infection, CorMatrix was used to repair the left ventricular apex and aorta. Three months later, a HeartWare HVAD (HeartWare International, Inc, Framingham, MA) was implanted for recurrent heart failure. Excised apical CorMatrix samples showed cardiac tissue remodeling with viable cardiomyoblasts similar to native myocardium...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760470/improved-approach-with-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-difference-in-on-and-off-pump
#8
COMPARATIVE STUDY
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Emily Phillips, Joyce Wald, Matthew L Williams, David W Low, Michael A Acker, Pavan Atluri
BACKGROUND: The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. METHODS: This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC)...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28651783/optimal-timing-of-heart-transplant-after-heartmate-ii-left-ventricular-assist-device-implantation
#9
COMPARATIVE STUDY
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216204/left-ventricular-assist-device-thrombosis-is-associated-with-an-increase-in-the-systolic-to-diastolic-velocity-ratio-measured-at-the-inflow-and-outflow-cannulae
#10
Ankit Jain, Ben Rohrer, Brian Gebhardt, Janis L Breeze, Joshua D Quick, Gregory Couper, Michael S Kiernan, Matthew Lawrence, Frederick C Cobey
OBJECTIVE: To determine whether the ratio of peak systolic-to-nadir diastolic velocity (S/D ratio) measured using Doppler at the left ventricular assist device (LVAD) inflow and outflow cannulae is associated with pump thrombosis and to determine whether there is an absolute decrease in the diastolic cannula velocities in LVAD thrombosis. DESIGN: Retrospective chart review. SETTING: University hospital. PARTICIPANTS: Patients who underwent LVAD exchange...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28070902/a-modified-lvad-technique-to-augment-caval-and-pulmonary-arterial-blood-flow-in-the-failing-fontan-circulation
#11
Michael F Swartz, Louis DiVincenti, Karen Smith, Robin Westcott, Kevin Belmont, William Harris, Francisco Gensini, George M Alfieris
BACKGROUND: There are minimal circulatory support options for patients with a failing Fontan. The Heartmate II (HMII) left ventricular assist device (Thoratec, Bedford, MA) in its packaged state cannot augment caval/pulmonary arterial blood flow. AIM: We hypothesized that a modified HMII pump could augment caval and pulmonary arterial blood flow. METHODS: A bifurcated ringed Gore-Tex graft (W. L. Gore & Associates, Flagstaff, AZ) was sewn to the HMII inflow, and the outflow graft transected and tapered from 16 mm to 8 mm in diameter...
February 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#12
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28024549/temporary-mechanical-circulatory-support-in-cardiac-critical-care-a-state-of-the-art-review-and-algorithm-for-device-selection
#13
REVIEW
A Dave Nagpal, Rohit K Singal, Rakesh C Arora, Yoan Lamarche
With more than 60 years of continuous development and improvement, a variety of temporary mechanical circulatory support (MCS) devices and implantation strategies exist, each with unique advantages and disadvantages. A thorough understanding of each available device is essential for optimizing patient outcomes in a fiscally responsible manner. In this state of the art review we examine the entire range of commonly available peripheral and centrally cannulated temporary MCS devices, including intra-aortic balloon pumps, the Impella (Abiomed, Danvers, MA) family of microaxial pumps, the TandemHeart (CardiacAssist Inc, Pittsburg, PA) pump and percutaneous cannulas, centrally cannulated centrifugal pumps such as the CentriMag (Thoratec Corp, Pleasanton, CA/St Jude Medical, St Paul, MN/Abbott Laboratories, Abbott Park, IL) and Rotaflow (Maquet Holding BV & Co KG, Rastatt Germany), and extracorporeal membrane oxygenation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27905492/high-fidelity-computational-simulation-of-thrombus-formation-in-thoratec-heartmate-ii-continuous-flow-ventricular-assist-device
#14
Wei-Tao Wu, Fang Yang, Jingchun Wu, Nadine Aubry, Mehrdad Massoudi, James F Antaki
Continuous flow ventricular assist devices (cfVADs) provide a life-saving therapy for severe heart failure. However, in recent years, the incidence of device-related thrombosis (resulting in stroke, device-exchange surgery or premature death) has been increasing dramatically, which has alarmed both the medical community and the FDA. The objective of this study was to gain improved understanding of the initiation and progression of thrombosis in one of the most commonly used cfVADs, the Thoratec HeartMate II...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#15
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
August 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27865732/prevention-of-heartmate-ii-pump-thrombosis-through-clinical-management-the-prevent-multi-center-study
#16
Simon Maltais, Ahmet Kilic, Sriram Nathan, Mary Keebler, Sitaramesh Emani, John Ransom, Jason N Katz, Brett Sheridan, Andreas Brieke, Gregory Egnaczyk, John W Entwistle, Robert Adamson, John Stulak, Nir Uriel, John B O'Connell, David J Farrar, Kartik S Sundareswaran, Igor Gregoric
BACKGROUND: Recommended structured clinical practices including implant technique, anti-coagulation strategy, and pump speed management (PREVENT [PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management] recommendations) were developed to address risk of early (<3 months) pump thrombosis (PT) risk with HeartMate II (HMII; St. Jude Medical, Inc. [Thoratec Corporation], Pleasanton, CA). We prospectively assessed the HMII PT rate in the current era when participating centers adhered to the PREVENT recommendations...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27772606/robotic-assisted-coil-embolization-of-ascending-aortic-pseudoaneurysm
#17
Tony Lu, Shayan Owji, Ponraj Chinnadurai, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
A 62-year-old man with coronary artery disease and ischemic cardiomyopathy after coronary artery bypass grafting and insertion of a HeartMate II (Thoratec, Pleasanton, CA) left ventricular assist device (LVAD) presented with spontaneous incisional bleeding and an ascending aortic pseudoaneurysm. Aortic angiography revealed an anomalous connection between the pseudoaneurysm and the LVAD conduit. We were able to partially embolize the tract with standard techniques, but the patient returned with repeated bleeding...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27766717/effect-of-ventricular-arrhythmia-ablation-in-patients-with-heart-mate-ii-left-ventricular-assist-devices-an-evaluation-of-ablation-therapy
#18
David Snipelisky, Yogesh N V Reddy, Kevin Manocha, Aalok Patel, Shannon M Dunlay, Paul A Friedman, Thomas M Munger, Samuel J Asirvatham, Douglas L Packer, Yong-Mei Cha, Suraj Kapa, Peter A Brady, Peter A Noseworthy, Joseph J Maleszewski, Siva K Mulpuru
BACKGROUND: Patients with advanced heart failure (HF) are predisposed to ventricular arrhythmias (VAs), particularly following implantation of a left ventricular assist device (LVAD). There is minimal evidence for appropriate management strategies. OBJECTIVES: This study aimed to compare the burden of VA and response to ablation performed either before or following LVAD implantation. METHODS: We created a retrospective cohort of patients who underwent both VA ablation and Heart Mate II (Thoratec, Pleasanton, CA, USA) LVAD implantation at Mayo Clinic (Rochester, MN, USA)...
January 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27746085/the-incidence-risk-factors-and-outcomes-associated-with-late-right-sided-heart-failure-in-patients-supported-with-an-axial-flow-left-ventricular-assist-device
#19
Jonathan D Rich, Igor Gosev, Chetan B Patel, Susan Joseph, Jason N Katz, Peter M Eckman, Sangjin Lee, Kartik Sundareswaran, Ahmet Kilic, Brian Bethea, Behzad Soleimani, Brian Lima, Nir Uriel, Michael Kiernan
BACKGROUND: Early right-sided heart failure (RHF) after left ventricular assist device (LVAD) implantation is associated with increased mortality, but little is known about patients who develop late RHF (LRHF). We evaluated the incidence, risk factors, and clinical impact of LRHF in patients supported by axial-flow LVADs. METHODS: Data were analyzed from 537 patients enrolled in the HeartMate II (HM II; Thoratec/St. Jude) destination therapy clinical trial. LRHF was defined as the development of clinical RHF accompanied by the need for inotropic support occurring more than 30 days after discharge from the index LVAD implant hospitalization...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27717422/left-ventricular-assist-device-design-reduces-von-willebrand-factor-degradation-a-comparative-study-between-the-heartmate-ii-and-the-evaheart-left-ventricular-assist-system
#20
COMPARATIVE STUDY
Carlo R Bartoli, Jooeun Kang, David Zhang, Jessica Howard, Michael Acker, Pavan Atluri, Tadashi Motomura
BACKGROUND: Supraphysiologic shear stress from continuous-flow left ventricular assist devices (LVADs) accelerates von Willebrand factor (vWF) degradation and predisposes patients to nonsurgical bleeding. It is unknown whether unique design characteristics of LVADs differentially affect vWF degradation. We tested the hypothesis that the centrifugal-flow EVAHEART (Evaheart, Houston, TX) left ventricular assist system (LVAS), which was designed to minimize shear stress (low operational revolutions per minute [rpm], larger flow gaps, low shear stress, flat H-Q curve), reduced vWF degradation versus the axial-flow HeartMate II (Thoratec, Pleasanton, CA) LVAD...
April 2017: Annals of Thoracic Surgery
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